Break the silence on teething gel ingredients

This is certainly news worth sharing if you know someone who has a teething baby. At some time or other, many parents use pain relief products bought from a local chemist. Most of us don’t look at the list of teething gel ingredients – I know I never did. I trusted well known brands to offer me a safe product. Yet, since January 2019, in the UK teething gel has been taken off the unmonitored shelves, and can only be bought over the counter under advisement.

Therefore, it’s worth considering what’s in teething gels, whether it’s necessary to use it and what alternatives there are.

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Why do we think baby needs teething gel?

As baby’s first teeth begin to come though, whether they are the very first front teeth, or the larger back teeth, they have to break through the surface of the gums, which often causes some discomfort. Most babies start teething any time between five to ten months. In rare cases, some babies are born with natal teeth or develop neo-natal teeth within the first few weeks, but that’s even more unusual. Some babies develop their teeth later too. Babies usually have their full set of twenty first teeth by their third birthday.

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The signs of an erupting baby tooth vary, but may include some or all of:

• increased restlessness and change in sleeping patterns
• more crying that’s more challenging to comfort
• wanting to chew, bite or gnaw
• drooling
• sensitive gums that apear redder than usual or swollen
• slight rise in temperature

Teething babies are also just as susceptible to illness as they are at other times.

Monitor your baby as usual if there are other concerns, such as, but not limited to, diarrhoea and/or vomiting, a rash, coughing or a high temperature. Always contact your healthcare professionals for advice if you are concerned for your baby’s health. In England, the National Health Service helpline is available 24/7 by freephone on: 111.

As teething can be uncomfortable for the baby, and disturbing for parents, there are a range of pain relief treatments available – including teething biscuits, rings, toys, granules and gels.

The decision for carers is what to use to try to ease the pain and help both baby and parent feel calmer.

Recent research highlights ingredients of teething gels

An article published in the British Dental Journal, on 27th September 2019, investigates the ingredients of teething gels, and other teething pain relief products.

The active ingredient approved for use in teething gels in the UK, is Lidocaine Hydrochloride. It’s a synthetic chemical compound, used as a local anaesthetic. Applied directly to the surface of tissue, it causes numbness and dulls feeling.

In teething gels, the concentration of Lidocaine is low. Of teething gels licenced for use in the UK, a product called Anbesol Teething Gel had the highest concentration of Lidocaine, at 1%w/w, compared to several products with the lowest quantity at 0.33%. It is worth noting that the well-known Bonjela Teething Gel has 0.33%, yet the Bonjela Junior Gel has 0.5%, so it’s worth checking the details and making the appropriate choice.

In addition, often teething gels include an antiseptic compound called Cetylpyridinium chloride (CPC) regularly found in mouth washes, toothpastes, nasals sprays and throat lozenges. It’s an effective ingredient for tacking oral bacteria and plaque, but in higher dose medicines has been linked to discolouration.

When getting a gel, it’s also worth looking at the list of excipients. It’s likely that Ethanol is the main carrier of the solution. It’s alcohol, distilled from plant materials.

Of course, these gels come in small tubes, and only a smear is used. Clear instructions will explain quantity and frequency of use, to keep the product safe. As with all medications, if you notice an allergic reaction, such as swelling or a rash, or any unexpected response, discontinue use immediately and consult your doctor.

Are teething powders or granules any better?

The UK approved teething powders and granules are classified as either homeopathic or herbal. With these, though, what we need to look out for is the inclusion of sucrose. That’s sugar. As the sachet is emptied into baby’s mouth and the contents combine with the saliva, caoting the gums and any teeth, it will encourage bacteria to form plaque. Therefore, especially for older babies with more advanced dentition, it’s worth finding a brand that is sugar-free or using an alternative.

So what are the alternatives to teething products?

It’s good to avoid:

• anything baby can swallow, such as a string of beads which could break
• very cold items, such as chilled teething rings, or something frozen
• items with sharp edges or hard surfaces
• chewing biscuits or ‘teething rusks‘ with a high level of sugar
• offering fruit juice to drink
• any other medications, such as paracetamol based pain relief for babies

To relieve pain:

• offer baby carrots or cucumber to chew on, if old enough
• try some toast, or baked bread (again, as age appropriate, but remember to check the ingredients on bread, as some trusted brands use caramelised sugar for colouring)
• offer a drink of water or milk
• massage the sore area of baby’s gums with a clean finger, piece of clean lint or flannel (chewing allowed too!)
• distract baby with games, songs or movement

With a few alternative strategies up our sleeves, we may be able to reduce the need for gel.

We should keep in mind too, that if we read the labels and follow the instructions these medications are licensed and considered safe. They can be an enormous help so parents and baby pass a more peaceful and relaxed night, which is important.

SpaDental promotes children’s health

Our community outreach team visits local schools to help children learn about oral health and value their teeth.

Practices providing NHS care, are encouraging parents to register their children. We’re supporting government initiatives such as Dental Check by 1 and Starting Well.

• Find and contact your local SpaDental practice.
• SpaDental Whitchurch is registering babies, children and teenagers as NHS patients.

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